At a glance: Ghana

Northern Ghana remains vigilant against Guinea worm

Azaratu Zakaria, her leg twisted into a permanent limp as a result of Guinea worm infections, is happy to be helping her community erradicate the disease.

By Madeleine Logan

DIARE, Ghana , 28 December 2011 – Azaratu Zakaria once limped unnoticed through the dusty lanes of her village. Now she is approached by strangers who call her an ambassador – something which she, as a woman with a disability in rural Ghana, never thought possible.

The change happened in July of this year, after she appeared on television alongside Ghana’s Vice President John Dramani Mahama to celebrate the country’s success in breaking the transmission of Guinea worm – the final step before the country can claim it has eradicated the disease. The spotlight was on Ms. Zakaria, who was the last known person in Ghana to be infected with the parasite.

This month, UNICEF and partners will host a team assessing the country’s readiness to be declared Guinea worm-free. It has been 17 months since Ms. Zakaria was infected – more than the maximum gestation period of the disease. But three years must pass without any new cases before the disease is officially considered eradicated.

Living with the pain

For most of Ms. Zakaria’s life, the spaghetti-like, metre-long Guinea worms caused her intense pain, sometimes forcing her to crawl around on hands and knees.

“I had Guinea worm nearly every year of my life, and the pain was so bad I couldn’t sleep,” she said. “The pain went on all day and all night. I couldn’t farm, go to fetch water or wash for my family.”

Ms. Zakaria now knows the disease is spread by drinking water contaminated with a tiny water flea that carries Guinea worm eggs. After they are ingested, the eggs hatch, and the worms force their way out through the skin, sometimes causing permanent damage in the process.

The last time she was infected, in May 2010, she went immediately to the Guinea Worm Containment Centre for treatment, resisting the urge to dip her foot in water to relieve the pain. Because contact with water prompts the worm to release its eggs, stepping into a water source can threaten a whole community with infection.

Fighting back

Symptoms used to appear during the wet season, incapacitating villagers, bringing farming to a standstill, and keeping children from school. In 2006, 4,130 cases of Guinea were reported in Ghana – the second highest number of any country in the world .

UNICEF and partners stepped up efforts to fight back.

UNICEF focused on providing safe drinking water, distributing water filters and spraying dams with a mild pesticide to kill the flea that carries Guinea worm. But the key has been changing people’s behaviours when collecting and drinking water.

“We collaborated with teachers, volunteers, chiefs and opinion leaders,” said Abdul Rahaman Lansah, who coordinated the effort in Savelugu-Nanton District. “Volunteers went on motorbikes from house to house, community to community, convincing women of the benefits of filtering water and educating people to report any blister that could be a Guinea worm.”

Volunteer guards were sent out to dams to ensure everybody used filters and nobody stepped into the waterhole, contaminating the supply. Boys selling water to the community were convinced to filter it first.

A curious turnaround

In a curious turnaround, the disease that was once the source of Ms. Zakaria’s misery has now earned her respect from the community.

“Where I go, people tell me they saw me on TV. They say I’m like an ambassador for the community,” she said.

She now uses her celebrity in the Savelugu-Nanton District , which once had the highest number of reported Guinea worm cases , to implore people to be vigilant against the disease.

“I’ve become an inspector of sorts. If I see children with sores or who are limping, I want to know why and check it’s not Guinea worm. I tell people that I’ve had enough Guinea worm for everybody,” she said.

Today, with Ghana tantalizingly close to declaring an end to the disease, Ms. Zakaria’s only regret is that the Guinea worm programme did arrive sooner.

“If it had been there when I was infected as a child, I would have walked normally. I would have been saved,” she said. “All I pray for now is for no other person to get Guinea worm.”